James Delles is about to become a fixation of the nation’s health care marketers.

At 27, he’s young, healthy and has been without health insurance for most of the past four years. Soon he will have a decision to make.

“I’ve heard about the exchanges,” said Delles, who recently moved from Chico, Calif., to become a graduate student at the University of Minnesota. “They’re supposed to be cheaper because you can bundle a lot of people in one place. But I don’t really know how they work.”

As summer winds down and the Oct. 1 launch of Minnesota’s new MNsure health care exchange draws near, the state is betting millions that a pair of venerable Minnesota icons can grab the attention of young people like Delles and persuade them to buy coverage.

Starting Monday, images of legendary lumberjack Paul Bunyan and his blue ox, Babe, will appear in newspapers, skyways, billboards and bus stops, as part of a campaign, titled “Minnesota, Land of 10,000 Reasons to Get Health Insurance,” April Todd-Malmlov, MnSure’s executive director, said Sunday.

In coming weeks, the pair also will appear at MNsure’s State Fair booth and show up at community events and in television ads, online videos and social media.

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MMsure's marketing on a stick.

It’s a crucial moment for supporters of President Obama’s health care law. The new online marketplaces must attract young and healthy people to keep premiums low and cover the costs to insure those with expensive medical needs.

The Minneapolis advertising agency that is coordinating the $9 million campaign, BBDO Proximity, faces a mammoth task. Polls show that nearly 40 percent of Americans don’t understand Obama­care and nearly one in five don’t even realize it’s the law.

‘Incredibly high’ stakes

“The stakes are incredibly high,” said Andy Hyman, a senior program officer with the Robert Wood Johnson Foundation. “This is a historic moment — a chance to expand health coverage to a level we’ve not seen in most of our lifetimes.”

In a sound studio in downtown Minneapolis, representatives from BBDO and MNsure huddled late last week to record voice-overs and put finishing touches on the multi­pronged marketing campaign. The blitz strikes up in earnest after Labor Day, when call centers open to answer an expected flood of questions.

“It was strategic,” said Todd-Malmlov. “You don’t want to get the word out before there’s an action people can take.”

On Sunday, Brian Kroening, executive creative director of BBDO Proximity, showed reporters a video of ad excerpts. One video showed Paul Bunyan water skiing off Lake Waconia and into a tree.

“We won’t be afraid to let people smile,” Kroening said. “Everyone knows not having insurance is scary. I don’t need to remind them of that.”

He said Paul and Babe beat out two other characters, whom he wouldn’t name, in market research to be campaign stars. The Orman Research firm found the legendary pair resonated with people in focus groups in six regions of the state, Kroening said.

The federal government is pumping $22 million into Minnesota to get the word out about MNsure, which could draw as many as 975,000 Minnesotans in 2014, according to state estimates. The exchange will be used by individuals who don’t get workplace coverage, businesses with 50 or fewer employees and those covered by public programs. Most of the funds will be used to train and hire navigators to help people in such places as health clinics, businesses, libraries and religious institutions to shop on the MNsure website.

But MNsure’s message will be just one of many vying for consumers’ attention in the coming months. Insurance companies will be trying to reach the half-million Minnesotans currently uninsured, seeking to sway additional enrollees into their plans.

Obamacare opponents also will be speaking out. A new billboard near the State Fairgrounds urging consumers to “refuse MNsure” may be the opening salvo.

$500 million for advertising

Nationwide, supporters and detractors of Obamacare are expected to spend more than $500 million in the next six months to push their messages, according to Ad Age.

“It’s going to be noisy,” Hyman said. “Marketers of the exchange will need to find ways to break through.”

George John, who chairs the marketing department at the University of Minnesota’s Carlson School of Management, said the marketing blitz may be unprecedented.

“The debate over Medicare in 1965 was much less contentious. The dollars weren’t so great, and no one foresaw how it would transform society,” he said. “Now we’re fed a steady diet of prognostication and forecasting. There’s just so much information out there that every issue becomes magnified. And this is probably the issue to end all issues.”

BBDO Proximity opened in 1930 with an account for Hormel Foods, which remains a client today. The agency has designed ads for financial services firms, real estate and well-known local and national brands. BBDO also has worked with states in the past, including lottery and tourism promotions and a stop-smoking campaign in New Jersey.

Last April, BBDO beat out 10 competitors for the one-year, $666,590 contract to build MNsure’s public awareness and education campaign. By that time, the state already had selected a name and logo and had done a good bit of consumer research.

The first round of ideas the BBDO team took to Todd-Malmlov and MNsure’s marketing director, Mary Sienko, yielded a “refreshing” response, said BBDO group account director Leslie Sipprell, who is overseeing the MNsure campaign.

“April said, ‘This is good, but push it even further,’ ” Sipprell said. “It could have been very easy to play it safe. They wanted something fresh and unexpected.”

A team at BBDO Proximity quickly took a handful of ideas on the road and tested them in Bemidji, Duluth, St. Cloud, Marshall, Rochester and the Twin Cities. The direction, they said, was clear. “People are so cynical and beaten down,” Sipprell said. “We heard, ‘This makes us laugh and want to buy insurance.’ ”

A difficult mission

Ads are only part of the outreach campaign. Influencing people’s behavior over something as complex and politicized as health care will require a different approach than enticing consumers to switch to a new brand of laundry detergent, said the U’s George.

“To get my 23-year-old son to sign up for insurance is a far different matter than to get him to trade in his old phone to get a new phone,” George said. “The success or failure of the exchange is not going to turn on some clever ad campaign or having a Twitter account with some creative copywriter.”

To get people to do big things differently, you have to engage them and set up institutional structures to support the choice, he said. Giving blood, for instance. The Red Cross shows up, makes it simple, and sets up in a prominent place that people can’t walk past without feeling guilty.

“Think of this as the moral equipment of the bloodmobile and the gurneys in the office lobby,” George said. “If you can make it easy for my son to sign up, he’ll do it.”

In public presentations about the broad-based campaign, MNsure officials seem confident that they have the bases covered. They plan to use a variety of media tactics to hit people with “memorable messages.”

“In other words,” one presenter said, “we want to stop people in their tracks.”

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